Apparatus, system and method for manipulating a surgical catheter and working device with a single hand

ABSTRACT

Systems and methods are disclosed that include a guide catheter apparatus insertable through a external body passage of a subject. The guide catheter apparatus includes a substantially rigid shaft and a handle. The shaft has a proximal opening, a distal opening, and a lumen extending between the proximal opening and the distal opening. The handle has a structure to allow a position of the guide catheter to be controlled by some or all of three fingers of one hand of an operator of the handle. The structure of the handle is adapted to permit the operator to position a thumb and index finger of the hand to manipulate a working device inserted into the lumen of the guide catheter, where the working device is manipulable via a portion of the working device immediately adjacent to the handle.

CROSS-REFERENCES TO RELATED APPLICATIONS

The present application is a continuation of U.S. application Ser. No. 14/691,438 filed Apr. 20, 2015, now U.S. Pat. No. 10,413,714, which is a continuation of U.S. application Ser. No. 12/454,560 filed May 18, 2009, now U.S. Pat. No. 9,011,412, which claims the benefit under 35 U.S.C. § 119(e) of U.S. Provisional Patent Application No. 61/127,848 filed May 16, 2008, all of which are incorporated herein by reference in their entirety as if fully set forth herein.

TECHNICAL FIELD

The present invention is generally directed to surgical devices and, in particular, to an apparatus, system and method for manipulating a surgical catheter and working device with a single hand.

BACKGROUND

FIG. 1 presents a schematic diagram of a typical surgical catheter (or guide) 100 that may be used to perform a procedure in a nasal, sinonasal, or oral passage or other external body passage. The catheter 100 includes a tube 102 having therein a duct 104. The tube 102 may be introduced into the body passage and a guidewire or other working device inserted into the duct 104 via an opening 106 at a proximal end of the catheter 100. The duct 104 then operates to guide the working device to an opening 108 at a distal end of the tube 102. A handle 110 may be formed into or attached to the proximal end of the tube 102 to permit positioning of the catheter 100 by movement of the catheter 100 into and out of the body passage and rotation of the catheter 100 around a longitudinal axis with a first hand. Once a desired position is obtained, the catheter 100 with fingers of a second hand that also grasps an endoscope and held in position. The first hand may then be used to manipulate the working device inserted into the duct 104.

SUMMARY OF THE INVENTION

This disclosure provides an apparatus, system and method for manipulating a surgical catheter and working device with a single hand.

In one embodiment, a system includes a guide catheter, a working device and a handle coupled to the guide catheter. The guide catheter is insertable through an external body passage of a subject, and includes a substantially rigid shaft, a proximal opening, a distal opening and a lumen extending between the proximal opening and the distal opening. The working device is adapted to be insertable through the lumen of the guide catheter. The handle has a structure that allows a position of the guide catheter to be controlled by some or all of three fingers of one hand of an operator of the handle. The structure of the handle is adapted to permit the operator to position a thumb and index finger of the hand to manipulate the working device via a portion of the working device that is immediately adjacent to the handle.

In another embodiment, a method includes inserting a guide catheter through an external body passage of a subject, inserting a working device through the lumen of the guide catheter, and controlling a position of the guide catheter using a handle affixed to the guide catheter while substantially simultaneously manipulating the working device. The position of the guide catheter is controlled by some or all of three fingers of a hand and a thumb and index finger of the hand manipulate the working device via a portion of the working device immediately adjacent to the handle.

In still another embodiment, a guide catheter apparatus insertable through a external body passage of a subject includes a substantially rigid shaft and a handle. The shaft has a proximal opening, a distal opening, and a lumen extending between the proximal opening and the distal opening. The handle has a structure to allow a position of the guide catheter to be controlled by some or all of three fingers of one hand of an operator of the handle. The structure of the handle is adapted to permit the operator to position a thumb and index finger of the hand to manipulate a working device inserted into the lumen of the guide catheter, where the working device is manipulable via a portion of the working device immediately adjacent to the handle.

BRIEF DESCRIPTION OF THE DRAWINGS

For a more complete understanding of the present invention and its advantages, reference is now made to the following description taken in conjunction with the accompanying drawings, in which:

FIG. 1 presents a schematic diagram of a surgical catheter;

FIG. 2 presents a schematic diagram of a surgical catheter according to this disclosure;

FIG. 3 presents a schematic diagram of another surgical catheter according to this disclosure;

FIG. 4 presents a schematic diagram of a surgical catheter according to this disclosure with working devices inserted;

FIG. 5 presents a schematic diagram of a surgical catheter according to this disclosure held by a user; and

FIG. 6 presents a schematic diagram of still another surgical catheter according to this disclosure.

DETAILED DESCRIPTION OF EXEMPLARY EMBODIMENTS

FIG. 2 depicts a schematic diagram of a surgical catheter 200 according to the present disclosure. The catheter 200 includes a tube 202 having therein a duct 204 with an opening 208 at a distal end. A handle 210 may be formed into or attached to the proximal end of the tube 202. A Y-shaped section 212 is coupled to a proximal end of the tube 202 at a distal end of the section 212. The section 212 includes a second handle 218 and an opening 216 at a proximal end of the section 212. The section 212 includes a duct 214 that mates with the duct 204 of the tube 202. As described for the catheter 100, working devices may be inserted in the opening 216 and guided to the opening 208 at the distal end of the tube 202 by the duct 214 and the duct 204.

The section 212 further includes a branch section 212A having a branch duct 214A. Suction may be applied to the catheter 200 via the branch section 212A. Where both the opening 216 and the opening 208 are left uncovered, the suction will be conducted to the opening 216 via the ducts 214A and 214 and to the opening 208 via the ducts 214A, 214 and 204. Because the tube 202 is inserted into a body passage and, possibly, through a hole in a membrane of the body, the opening 208 may be sealed off from the ambient air pressure outside the catheter 200. In such a situation, the suction applied to the branch section 212A will primarily result in air being drawn through the opening 216 and into the duct 214A.

Partially or completely blocking the opening 216, however, will result in the suction drawing blood, mucous, and other materials into the opening 208 and along the ducts 204, 214 and 214A, resulting in removal of the materials from the vicinity of the distal end of the tube 202. An operator of the catheter 200 may vary the mount of blockage of the opening 216 with a finger or valve, in order to control the amount of suction delivered to the opening 208. In this way, materials produced by the body in response to operation of the working devices (or freed from the body by the operation of the working devices) may be removed from vicinity of the distal end of the tube 202 by way of a controlled amount of suction. Such removal may provide a clearer view for an endoscope inserted into the catheter 200, a clearer working area for a cutter, or other similar benefits.

A coupling 220 at a proximal end of the branch section 212A couples a tube 222 having a duct 224 to the branch section 212A and the duct 214A, respectively. The tube 222 may conduct the suction to the section 212 from a suction canister or other suction source. Where the tube 222 is stiff, the coupling 220 may permit rotation of the branch section 212A relative to the tube 222, to reduce interference by the tube 222 with an operator's positioning of the catheter 200.

In another embodiment, a coupling 226 at a proximal end of the tube 222 may couple a second tube 228 having a duct 230 to the tube 222 and the duct 224, respectively. The coupling 220 does not permit rotation of the tube 222 relative to the branch section 214A, nor does the coupling 226 permit rotation of the tube 228 relative to the tube 222. However, where the tube 228 is stiff, a flexible tube 222 may be employed to reduce interference by the tube 228 with an operator's positioning of the catheter 200.

While the section 212 is shown and described as separate from the tube 202, it will be understood that in other embodiments, the section 212 may be formed integrally with the tube 202. In still other embodiments, the coupling 220 may be mounted directly to a side of the section 212, rather than to the branch section 212A. While the section 212 is shown fixedly attached to the tube 202, in other embodiments the section 212 may move relative to the tube 202, in order to further free tethering and increase a user's free and unencumbered movements in space, while leaving the tube 202 in a substantially fixed position relative to the patient's body. In such embodiments, the section 212 may rotate freely or be moved to a desired position and then locked into place via a suitable locking mechanism.

FIG. 3 presents a schematic diagram of a second surgical catheter 300 according to the disclosure. The catheter 300 includes a body having a handle 350. At a distal end of the catheter 300 is a guide coupling 310, which may be a rotating ‘female’ luer lock. The guide coupling 310 accepts and locks a guide 302. The coupling also operates to permit the guide 302 to be rotated to a desired position relative to the handle 350 and locked in that position for use. The guide coupling 310 may include detents to allow the guide 302 to be positioned only at predetermined positions relative to the handle 350.

The handle 350 may include concavities 356 adapted to provide a secure grip on the handle 350 by some or all of the middle, ring and little fingers of a user's hand, as will be described in greater detail with reference to FIG. 5. The handle 350 may include a protrusion 352 adapted to a secure grip on the handle 350 by a user when the upper portion of the handle 350 is positioned between the middle and ring fingers while grasping the lower portion of the handle 350 with the ring and little fingers.

The handle 350 includes a duct 314 that passes from the guide coupling 310 to an opening 318 at a distal end of the handle 350. The duct 314 is aligned with a duct in the guide 302 when the guide 302 is mounted in the guide coupling 310, so that an endoscope, guidewire or other working device may be inserted into the opening 318, pass through the duct 314 and the guide 302 to emerge from a distal end of the guide 302. A branch section 314 a of the duct 314 extends through the handle 350 to a handle coupling 320. A source of suction may be attached to the handle 350 at the handle coupling 320 to provide suction at the distal end of the guide 302, as described with reference to FIG. 2.

Where the opening 318 is provided with a one-way valve to prevent air being drawn into the opening 318 by suction in the branch section 314 a, an opening 354 may be provided between the branch section 314 a and the exterior of the handle 350 to allow the user to control the amount of suction present at the distal end of the guide 302.

The handle 350 may be provided with a locking screw 358. Once a user has inserted a guide catheter through the duct 314 to a desired position within the patient, the user may operate the locking screw 358 to hold the guide wire in position while inserting another working device, such as a balloon catheter, along the guide wire. Once the second working device reaches the position of the locking screw 358, the locking screw 358 may be operated to withdraw it from the duct 314 and allow the second working device to continue along the duct 314.

With reference to FIG. 4, a balloon catheter 454 has been inserted into the opening 318 and through the guide 302. The balloon catheter 454 includes a tube 452 coupled to an inflation device. Operation of the inflation device causes an inflation segment 456 of the balloon catheter 454 to inflate. The handle 350 may be designed so that the distance between the opening 318 and the guide coupling 310 (indicated by the letter a), when added to the length of the guide 302 (indicated by the letter b), totals less than the distance between the attachment of the tube 452 at a proximal end of the balloon catheter 454 and the inflation segment 456 (indicated by the letter c).

Furthermore, the distance between the opening 318 and the guide coupling 310 may be selected based upon a distance between a shoulder feature of the proximal end of the balloon catheter 454 and the inflation segment 456. The distance may be selected to allow the shoulder feature to engage the opening 318 while the inflation segment 456 extends past the distal end of the guide 302 substantially only far enough to inflate without interference from the distal end of the guide 302. In this way, motion of the inflation segment 456 towards or away from the guide 302 during inflation may be minimized to reduce the likelihood that the inflation segment 456 will slip out of position when inflated.

A suction tube 428 may be attached to the handle coupling 320 by a tube coupling 422. Where the suction tube 428 is stiff, the tube coupling 422 (or the handle coupling 320) may be flexible and/or rotate to reduce interference by the stiff tube 428 with positioning the surgical catheter 300.

FIG. 5 illustrates the surgical catheter 300 in use. A surgeon or other user holds the handle 350 in a hand by some or all of the small finger, the ring finger and the middle finger. Gripped in this way, the surgeon may move the guide 302 in the direction of its longitudinal axis, may rotate the guide 302 about its longitudinal axis, or may rotate the guide 302 about an axis other than its longitudinal axis (‘yaw’). The fore finger and thumb are left free to manipulate a working device inserted into the opening 318 or to cover the opening 318 to redirect suction to the distal end of the guide 302, as described with reference to FIG. 2. As described with reference to FIG. 4, flexibility and/or rotation of the couplings 320 and/or 422 may reduce the interference of a stiff suction tube 428 on such motion.

The lower portion of the handle 350, which is grasped by the fingers, makes an angle with the upper portion of the handle, and with the guide 302, that facilitates the user's manipulation of working devices with the thumb and forefinger of a hand while grasping the handle with some or all of the remaining fingers of the hand. That is, the angle may be selected to place the user's thumb and forefinger in comfortable proximity to the opening 318, and the handle shaped to permit easy motion of the thumb and forefinger towards and away from the opening 318 while securely grasping a working device inserted through the handle 350 into the guide 302. As shown in the figures, that angle may be approximately sixty (60) degrees, although other angles that are less than ninety (90) degrees and more than zero (0) degrees may be employed.

Using the handle 350, the user is enabled to control the position of the guide 302 by positioning the arm and wrist of the hand that is grasping the handle, while simultaneously controlling the position of a working device inserted into the guide 302 with the thumb and forefinger of the same hand. This leaves the user's other hand free for other activities, such as holding an endoscope in position to view the distal ends of the guide 302 and the working device. In this way, the user is able to simultaneously control the position of the distal end of the guide 302 adjacent to a desired region of the patient and manipulate the working device with one hand.

FIG. 6 illustrates a handle 650 according to the present disclosure wherein the upper portion of the handle 650 comprises a pivot 652. The upper portion includes an opening 618 and a main duct and guide coupling (not shown, but similar to the duct 314 and the guide coupling 310) are in a fixed position relative to each other and to the pivot 652. The duct branch in the handle 650 (not shown, but similar to the branch duct 314 a) is pivotally coupled to the main duct, to allow suction applied to a handle coupling 620 to be applied to the opening 318 and a guide attached to the guide coupling. The pivot 652 allows the handle 650 to be rotated to a desired angular position relative to the upper portion and locked into the desired position.

Although the present invention and its advantages have been described in the foregoing detailed description and illustrated in the accompanying drawings, it will be understood by those skilled in the art that the invention is not limited to the embodiment(s) disclosed but is capable of numerous rearrangements, substitutions and modifications without departing from the spirit and scope of the invention as defined by the appended claims. 

What is claimed is:
 1. A surgical catheter adapted to facilitate manipulation of a guide and a working device with a single hand, the surgical catheter comprising: a handle having an upper portion and a lower portion; the upper portion of the handle having a working-device opening at a proximal end thereof and a guide coupling at a distal end thereof; the lower portion of the handle having a handle coupling extending therefrom and concavities on a surface thereof, the concavities being disposed between the handle coupling and the guide coupling to facilitate gripping of the handle by fingers of one hand of an operator of the handle, the handle coupling being configured to couple to a source of suction; a guide having a proximal guide opening at a proximal end, a distal guide opening at a distal end, and a guide duct extending from the proximal guide opening to the distal guide opening, the proximal end of the guide having at least three protrusions around a periphery thereof and spaced from the proximal guide opening, the proximal end of the guide being configured to be inserted into the guide coupling such that the at least three protrusions are at least partially inserted into the guide coupling; a Y-shaped section disposed within the handle, the Y-shaped section having a working-device section and a branch section, the working-device section having a first opening at a proximal end thereof, a second opening at a distal end thereof, and a working-device duct extending from the first opening to the second opening; wherein the working-device duct is generally aligned with the guide duct when the guide is inserted in the guide coupling, such that a working device may be inserted into the first opening of the Y-shaped section, pass through the working-device duct and the guide duct to emerge from the distal end of the guide; the branch section having a third opening and a branch duct extending from the third opening to the working-device duct, the third opening being coupled to the handle coupling and configured to couple the source of suction to the working-device duct to provide suction at the distal end of the guide; wherein the handle is adapted to permit the operator to grip the lower portion of the handle using fingers of the one hand while simultaneously positioning a thumb or forefinger of the one hand to manipulate the working device via a portion of the working device immediately adjacent the upper portion of the handle; a balloon catheter inserted into the first opening of the Y-shaped section and through the guide when the guide is inserted in the guide coupling, the balloon catheter having an inflation segment at a distal end thereof; wherein the balloon catheter includes an inflation tube coupled to the balloon catheter at a shoulder feature, the inflation tube configured to be coupled to an inflation device such that operation of the inflation device causes the inflation segment of the balloon catheter to inflate; and wherein the handle is configured such that the operator may manipulate the inflation segment of the balloon catheter relative to the distal end of the guide by moving the shoulder feature towards or away from the working-device opening and manipulate the working device via a portion of the working device disposed between the shoulder feature and the working-device opening.
 2. The surgical catheter of claim 1, wherein the handle is configured such that a first distance between the working-device opening and the guide coupling, when added to a length of the guide extending from the guide coupling when the guide is inserted therein, totals less than a second distance between the shoulder feature and the inflation segment of the balloon catheter.
 3. The surgical catheter of claim 1, wherein a longitudinal axis of the guide forms an angle of more than zero degrees with a longitudinal axis of the handle coupling extending from the lower portion of the handle.
 4. The surgical catheter of claim 1, wherein the working device may be moved relative to the guide, while leaving the guide in substantially fixed position relative to a patient's body.
 5. The surgical catheter of claim 1, wherein the handle includes at least one protrusion to facilitate the operator securing the handle.
 6. The surgical catheter of claim 1, wherein the wherein the guide coupling operates to permit the guide to be rotated to a desired position relative to the handle and lock the guide in the desired position for use.
 7. The surgical catheter of claim 1, wherein the at least three protrusions are at least partially inserted into the guide coupling to allow the guide to be positioned only at predetermined positions relative to the handle.
 8. The surgical catheter of claim 1, wherein the concavities are adapted to provide a secure grip on the handle by some or all of the middle, ring, and little fingers of the one hand of the operator.
 9. A surgical catheter comprising: a guide having a guide opening at a distal end thereof, a proximal edge at a proximal end thereof, and a guide duct extending from the proximal end to the distal end, wherein the proximal end has one or more protrusions around a periphery thereof, the one or more protrusions being spaced from the proximal edge of the proximal end; a handle having a guide coupling at a distal end thereof that accepts and locks the proximal end of the guide, wherein the guide coupling operates to permit the guide to be rotated to a desired position relative to the handle and then locked in that position for use; wherein, when the proximal end of the guide is inserted into the guide coupling, the one or more protrusions are at least partially inserted into the guide coupling to allow the guide to be positioned only at predetermined positions relative to the handle; a Y-shaped section disposed within the handle, the Y-shaped section having a first opening at a proximal end thereof, a second opening at a distal end thereof, a working-device duct extending from the first opening to the second opening, and a branch duct extending from the working-device duct to a third opening at an end of a branch section of the Y-shaped section; wherein the working-device duct is generally aligned with the guide duct when the guide is inserted in the guide coupling, such that a working device may be inserted into the first opening of the Y-shaped section, pass through the working-device duct and the guide duct to emerge from the distal end of the guide; wherein the third opening of the Y-shaped section is coupled to a handle coupling protruding from a lower portion of the handle, the handle coupling being configured to be coupled to a source of suction to provide suction at the distal end of the guide via the branch duct, the working-device duct, and the guide duct; a balloon catheter inserted into the first opening of the Y-shaped section and through the guide when the guide is inserted in the guide coupling, the balloon catheter having an inflation segment near a distal end thereof; wherein the balloon catheter includes an inflation tube coupled to the balloon catheter at a shoulder feature, the inflation tube configured to be coupled to an inflation device such that operation of the inflation device causes the inflation segment of the balloon catheter to inflate; and wherein the handle is configured to permit an operator to grip the lower portion of the handle using fingers of one hand and position a thumb or forefinger of the one hand to move the shoulder feature towards or away from the working-device opening.
 10. The surgical catheter of claim 9, wherein a lower surface of the handle has concavities disposed between the handle coupling and the guide coupling to facilitate gripping of the handle by the fingers of the one hand of the operator of the handle.
 11. The surgical catheter of claim 9, wherein the handle is configured to permit the operator to manipulate the working device via a portion of the working device disposed between the shoulder feature and the working-device opening.
 12. The surgical catheter of claim 9, wherein the handle is configured to permit the operator move the working device relative to the guide using the thumb or the forefinger of the one hand while leaving the guide in substantially fixed position relative to a patient's body.
 13. A system comprising: a catheter insertable through a body passage of a subject, said catheter having a substantially rigid shaft, a proximal opening, a distal opening, a first lumen extending between the proximal opening and the distal opening, and at least three protrusions around a periphery of a proximal end of the catheter, the at least three protrusions being spaced from the proximal opening of the catheter; a handle having a guide coupling at a distal end thereof that accepts and locks the proximal end of the catheter when the catheter is at a desired position relative to the handle, wherein the guide coupling is configured to receive the proximal end of the catheter such that the at least three protrusions of the catheter are at least partially inserted into the guide coupling to allow the catheter to be positioned only at predetermined positions relative to the handle; a Y-shaped section disposed within the handle and coupled to the proximal opening of the catheter at a distal end of the Y-shaped section and comprising a second lumen that aligns with the first lumen of the catheter, such that a working device may be inserted into the second lumen of the Y-shaped section at a proximal end thereof and pass through the first lumen to emerge from the distal opening of the catheter; the Y-shaped section having a branch duct extending from the second lumen to a handle coupling protruding from a lower portion of the handle, the handle coupling adapted to be coupled to a source of suction and the branch duct configured to couple the source of suction to the first lumen of the catheter via the second lumen of the Y-shaped section; a balloon catheter inserted into the second lumen of the Y-shaped section at the proximal end thereof and through the catheter when the catheter is inserted into the guide coupling, the balloon catheter having an inflation segment near a distal end thereof; wherein the balloon catheter includes an inflation tube coupled to the balloon catheter at a shoulder feature, the inflation tube configured to be coupled to an inflation device such that operation of the inflation device causes the inflation segment of the balloon catheter to inflate; and the handle having three concavities on a lower surface thereof to provide a secure grip on the handle by fingers of one hand of an operator of the handle, wherein the handle is adapted to permit the operator to position a thumb or forefinger of the one hand to manipulate the working device via a portion of the working device immediately adjacent to the handle.
 14. The system of claim 13, wherein a longitudinal axis of the handle coupling forms an angle with a longitudinal axis of the catheter of less than ninety degrees and more than zero degrees.
 15. The system of claim 13, wherein the handle is adapted to adjust to a desired value an angle between a longitudinal axis of the handle coupling and a longitudinal axis of the catheter.
 16. The system of claim 13, wherein the handle comprises an opening adapted to allow the operator of the handle to control an amount of suction coupled to the distal opening of the catheter.
 17. The system of claim 13, wherein the three concavities are disposed between four raised surfaces on the lower surface of the handle.
 18. The system of claim 13, wherein the three concavities are defined by four raised surfaces on the lower surface of the handle.
 19. The system of claim 13, wherein the handle is configured to permit the operator to position the thumb or forefinger of the one hand to move the shoulder feature towards or away from the proximal end of the Y-shaped section. 